Five Common Questions about Tubal Ligation, Answered

If you are a mother, your life probably looks something like mine: Most mornings start in a blurry-eyed haze because you haven’t slept more than four hours straight since your oldest child was born. A huge cup of coffee begins the marathon of a day, which consists of making sure that everyone else’s needs are tended to; preparing meals, washing clothes, and keeping your house in order. And that’s before we even think about our work obligations!

At the end of the day you fall into bed, sometimes half asleep before you actually hit the pillow. Just as you’re about to drift off into blissful sleep, your eyes pop open and your head flies from the pillow as you realize you forgot to take your birth control pill. 

You’re out of bed faster than you’ve moved in years to assure that not another minute passes before you take your dose, because you know that missing or skipping a pill could lead to you becoming pregnant again. 

In those moments, you may have wondered if permanent birth control, such as a tubal sterilization, tubal ligation, or “getting your tubes tied” might be a good option for you.

As an OB/GYN, my patients ask me a lot of questions about the risks and benefits of permanent birth control. Here’s some information that may be helpful in your quest to decide if this type of procedure is right for you. 

Will the surgeon tie my fallopian tubes in a knot?

“Getting your tubes tied” is a misnomer.

There is no procedure where the tubes are physically tied like you would a shoelace.

There are various ways a tubal sterilization can be performed. Historically, the procedure involved removing a portion of the fallopian tubes and ligating (closing off) the ends to stop the passage of sperm. 

More recently, providers are offering a procedure known as a bilateral salpingectomy, which is when both fallopian tubes are entirely removed. Some studies have shown that this procedure reduces a woman’s lifetime risk of developing ovarian cancer. 

Will my hormones and periods change after tubal ligation?

Many women think that having a tubal will change their hormones or set into motion early menopause. This is false. Tubal sterilization will not affect your hormone status. It should not cause the onset of menopause any earlier than your body was pre-determined to do so. 

Women often ask how their periods will change after a tubal. Studies have not consistently shown a change in a woman’s period following tubal sterilization. Anecdotally, some women have reported changes in their menses, but is not clear if these changes could be related to other factors, such as age.   

I can always have a tubal sterilization reversed, right?

This is the big one!

Any form of permanent sterilization, such as tubal ligation, should be consider just that – permanent

These procedures are not intended to be reversed. In some circumstances, surgery may be successful in reversing a tubal, but there is no guarantee that a pregnancy will be achieved afterwards. Before having the procedure, you and your partner (if you have one) should be absolutely certain that you do not want any children in the future.

Do I have to continue to take birth control after a tubal because it may not work?

Tubal sterilization is more than 99 percent effective in preventing pregnancy. After the procedure, you do not need to take birth control to protect yourself from pregnancy.

However! It’s important to remember that tubal sterilization does not protect against sexually transmitted infections. You will need to continue to use a barrier method (such as a condom) to prevent the spread of sexually transmitted diseases after your tubal.

Do I have to get my tubal in the hospital after giving birth?

No. A tubal can be performed at any time, as long as you are not pregnant. This is most commonly accomplished laparoscopically via small incisions on the abdomen. It is performed in the operative room under general anesthesia.

If you are currently pregnant and are planning on having a cesarean delivery, a tubal can be performed at the time of your C-section.

If you are pregnant and planning on a vaginal delivery, tubal sterilization can be performed after your delivery, usually under epidural or spinal anesthesia. 

If you’re ready to throw away your birth control and are certain that you’re done building your family, talk to your OB/GYN about tubal sterilization. It may be a great option for you.

Nina Nardello, DO is an OB/GYN at The Women’s Center of South Shore Medical Center and is accepting new patients. Learn more about Dr. Nardello and schedule an appointment on our website.